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NPI 1376450478

NPI 1376450478 : MUTZLACHIM INC : LAKEWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1376450478
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    Entity Type          |    Organization 
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    Legal Business Name  |    MUTZLACHIM INC 
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Dates
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    Enumeration Date     |    08/25/2026
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    Last Update Date     |    08/25/2026
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Provider Practice Location Address
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    Address Line         |    999 AIRPORT RD 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-5969
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    Country              |    US
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    Telephone            |    347-517-3434
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    554 DAVIDS CT 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-5884
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    Country              |    US
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    Telephone            |    347-517-3434
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     CHIZKYAHU  SHTUKMAN 
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    Credential           |    
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    Telephone            |    347-517-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    224Z00000X
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    Taxonomy Name        |    Occupational Therapy Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    
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    License Number State |    
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